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Invasive breast cancer — USMLE Step 2 CK MCQ

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ModerateSurgeryInvasive breast cancerUSMLE Step 2 CK

A 39-year-old Asian American man comes to the clinic because of progressive symptoms. History and focused examination are notable for hard irregular breast mass with skin dimpling and abnormal mammogram. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and imaging support an acute surgical process without suggesting a safer outpatient approach. Which of the following is the most appropriate initial diagnostic study?

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Correct answer: A — Core needle biopsy

The vignette describes Invasive breast cancer, supported by hard irregular breast mass with skin dimpling and abnormal mammogram. Core needle biopsy is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://www.ncbi.nlm.nih.gov/books/#stage-9-order-87